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DISCUSSION
Although the number of subjects reviewed
differences and trends noted for many of the observation points. The Amish are more likely to be homozygous for delta F508 as compared to the non-Amish FEV1, FEF 25-75, and BMI. Higher physical activity levels were found in
the Amish community compared to the non-Amish community. Despite higher numbers of prescriptions for supplemental nutrition, the Amish group had lower BMI, which may be secondary to increased physical activity and increased resting energy expenditure, which requires further exploration.
The result of our study showed that there is a substantial difference in bacterial colonization and antibiotic usage between Amish and non-Amish. The outcomes
are consistent with a recent study that has demonstrated an increased annual patients.19 has been considered a prevalent isolate, worsening of the lung function.
Minimization of the impact of infection and consequent pulmonary damage is
crucial. The problematic issue in the treatment of CF is an emergence and spread of antibiotic resistance. The extensive use of aggressive antibiotic therapies in CF has produced an increased risk of developing antibiotic resistance, as infected with P. aeruginosa are managed by administering inhaled antibiotics
in 28-day every month.21 Tobramycin antibiotics are often used to treat infection due to P. aeruginosa, Serratia Marcescens, and Burkholderia gladioli in the Amish population. However, tobramycin antibiotics are commonly used to treat infection with P. aeruginosa in the non- Amish community. Serratia marcescens and Burkholderia gladioli might be more frequent in Amish people due to their lifestyle, which requires further research.
CONCLUSION
This study analyzed the utilization
of services, access to care, and the corresponding clinical outcomes in the Amish compared to the non-Amish population. The research shows low
and insurance programs in the Amish community. Although the Amish use substantially more well water, they take care of their children and bring them to the clinic
during exacerbations. The study suggests that the differences in the Amish with concerning lifestyle and environment
can impact the outcomes of the care they receive. Adjustments in treatments to better serve the Amish population may be warranted. Further studies are needed to understand whether antibiotic therapy for of infective exacerbations is the best approach in the presence of novel antibiotic drug formulations.
ACKNOWLEDGEMENT
interest. The authors thank Gordon Bokhart, PharmD; Rachel McCafferty, Research Student; Alexis E. Schrieber, PharmD; and Alyaa Hussien, PharmD.
CONTRIBUTING AUTHORS
■ RAJESWARY PADMAN PADMALINGAM, MD, FAAP, FCCP is a Professor Emerita of Pediatrics
at Thomas Jefferson University, board-certified in pediatrics, pulmonology, and sleep medicine, and Director of Pediatric Pulmonology, Sleep Medicine, and Cystic Fibrosis at Lutheran Children’s Hospital, Jefferson Blvd., Fort Wayne, Indiana.
■ DENISE GILHAM is a Nurse Practitioner at Lutheran Children’s Hospital in Fort Wayne.
■ TINA LATURNER, RN is a Registered Nurse at Lutheran Children’s Hospital in Fort Wayne.
■ ALYAA HUSSIEN, PharmD, is a Pharmacist at Manchester University in Fort Wayne.
■ RON JONES is a Clinical Pharmacist
and Biostatistician with the Department of Pharmacy at Lutheran Hospital in Fort Wayne.
■ GORDON BOKHART, PharmD is a Research Director at Lutheran Hospital in Fort Wayne.
■ CHELSEA HAMILTON, PharmD, is a Pharmacist at Manchester University in Fort Wayne.
■ ABEER OMAR, PharmD, is a Pharmacy Manager at Frys Pharmacy in Scottsdale, AZ.
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